Healthcare Exchanges

Doctor tapping Affordable Care Act on virtual screen
Lin Grensing-Pophal, SPHR Photo
Contributing Writer

2 minutes

What role is the healthcare marketplace playing in the employee benefits landscape?

One impact of the Affordable Care Act is a move toward healthcare exchanges, also known as the healthcare marketplace. A healthcare marketplace is a venue established to facilitate the purchase and sale of health insurance plans compliant with the ACA.

ConnectYourCare has been and expects to continue utilizing these healthcare marketplaces. “In terms of exchanges, we’re on a track to engage with private and public exchanges,” says Allen Pease, chief business development officer for Maryland-based ConnectYourCare , which is a third-party administrator that manages health savings accounts and administers benefit accounts, such as flexible spending accounts, COBRA and retiree payments. “More companies will be working with third-party administrators to put products on the exchanges.”

The idea behind a healthcare marketplace is to inject a bit of free market economics into the healthcare system to help promote efficient pricing and greater quality by encouraging competition among health insurance providers. It also provides greater choice and decision-making for companies and individual healthcare consumers.

“With the Affordable Care Act, our industry is more consumer-directed in terms of making decisions about prices and out-of-pocket expenses,” says Pease. “Banks, credit unions and third-party administrators are essential to this change so employees can manage their money for healthcare easily through their phones, computers and websites, with decision-making tools that help calculate how much money to add to their health saving accounts, for example. The employees, instead of the insurance companies, are the managers.”

However, exchanges may not be the perfect solution many are hoping for, says Charles Smithers, CEO of National Business Coalition on Health, Washington D.C. “Exchanges are not meeting with much success. The Affordable Care Act promised subsidies, but they are not materializing. We’re seeing fewer exchanges, so the independent market is the alternative. For example, [in Florida] Blue Cross Blue Shield has [a licensee] called Florida Blue. However, the problem with these plans is they are not reliable in holding down costs in the long term. They tend to creep up.”

Change as a Constant

Rising healthcare costs and the rollout of several ACA provisions mean credit unions will need to prepare for significant changes impacting them and their employees. These include changes in how benefits are managed and reported, as well as a reshuffling of traditional relationships between employers, employees, healthcare providers and the brokers and health plan administrators that act as middlemen.

In terms of future legislation, many experts are holding their breath to see what will develop as the political climate changes. “With 2016 an election year, we likely won’t see any major changes in healthcare,” says Smithers. “We’ll be looking to 2017 to see what happens when the new Congress sets its agenda.”

Lin Grensing-Pophal, SPHR, is a freelance writer and human resource management and marketing communication consultant in Chippewa Falls, Wis. She is the author of The Everything Guide to Customer Engagement (Adams Media, 2014) and Human Resource Essentials (SHRM, 2010).

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